2006 Florida Youth Substance Abuse Survey. Polk County Report

Transcription

1 2006 Florida Youth Substance Abuse Survey Polk County Report

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3 2006 Florida Youth Substance Abuse Survey Polk County Report

4 2006 Florida Department of Children & Families

5 EXECUTIVE SUMMARY T he Florida Legislature s 1999 Drug Control Summit recommended the establishment of an annual, multi-agencydirected, statewide school-based survey effort, combining several survey instruments, with specific variations in odd and even years. The Florida Youth Substance Abuse Survey (FYSAS), one of these instruments and the focus of this report, is administered to a county-level sample of students in even years, and a smaller statewide sample in odd years. The FYSAS is based on the Communities That Care Youth Survey, developed from the nationally recognized work of Dr. J. David Hawkins and Dr. Richard F. Catalano. It not only measures the prevalence of alcohol, tobacco and other drug use and delinquent behavior, but also measures the risk and protective factors related to these behaviors. The 2006 FYSAS was administered to 1,624 Polk County students in grades 6 through 12 in the spring of The results supply a valuable source of information to help reduce and prevent the use of alcohol, tobacco and other drugs by school-aged youth. Key Survey Results Strengths to Build on Marijuana use has declined in Polk County. Overall lifetime marijuana use has gone from 30.6% in 2000 to 20.7% in Overall past-30-day marijuana use has gone from 17.6% in 2000 to 9.9% in Surveyed students reported a substantial reduction in past-30-day cigarette use. The rate dropped from 23.3% in 2000 to 12.7% in Past-30-day prevalence rates for Rohypnol (0.9%), GHB (0.6%), ketamine (0.5%), crack cocaine (1.0%) and steroids (0.6%) are all 1.0% or less. Relatively few students reported that they would be seen as cool by their peers if they drank alcohol regularly (12.9%), smoked cigarettes (6.4%) or smoked marijuana (11.3%). A substantial proportion of students indicated that it would be wrong or very wrong for someone their age to smoke cigarettes (76.9%), smoke marijuana (82.7%) or use other illicit drugs (93.9%). A majority of respondents reported that each of the following behaviors poses a great risk of harm: smoking a pack or more of cigarettes per day (63.3%) and regular use of marijuana (62.7%). Prevalence rates for Attempting to Steal a Vehicle (3.3%) and Taking a Handgun to (1.3%) are both less than 5.0%. Opportunities for Improvement With overall prevalence rates of 52.4% for lifetime use and 30.3% for past-30-day use, alcohol is the most commonly used drug among Polk County students. Binge drinking (defined as the consumption of five or more drinks in a row within the last two weeks) is more prevalent than past-30-day tobacco and marijuana use.

6 After alcohol, students reported cigarettes (32.4% lifetime and 12.7% past-30-day) and marijuana (20.7% lifetime and 9.9% past-30-day) as the most commonly used drugs. More than one student out of every 10 reported lifetime use of any illicit drug (29.4% lifetime and 15.0% past- 30-day). Polk County students reported the lowest level of protection for Community Opportunities for Prosocial Involvement (36). Polk County students reported one of their highest percentile scores for the community risk factor scale Low Neighborhood Attachment (59). This means that students are less likely to become involved with prosocial organizations and positive role models in their communities. Polk County students reported one of their lowest percentile scores for the reward-based protective factor scale Family Rewards for Prosocial Involvement (41). This means that families need to provide additional positive feedback to students, to help them form prosocial bonds in their families. Fewer students reported the perception that regular use of marijuana is harmful than did so in the past. The percentage of students reporting that smoking marijuana regularly poses a great risk of harm decreased from 65.8% in 2000 to 62.7% in Of surveyed Polk County students, 20.3% reported Getting Suspended, 13.0% reported Attacking Someone with Intent to Harm and 12.7% reported Being Drunk or at. These key findings illustrate the complexity of drug use and antisocial behavior among Polk County s youth and the possible factors that may contribute to these activities. While some of the findings compare favorably to the national findings, Polk County youth are still reporting drug use and delinquent behavior that will negatively affect their lives and our society. The FYSAS data will enable Polk County s planners to learn which risk and protective factors to target for their prevention, intervention and treatment programs.

7 Table of Contents METHODOLOGY... 1 VALIDITY OF SURVEY DATA... 1 WEIGHTING... 1 CONFIDENCE INTERVALS... 2 DEMOGRAPHICS... 2 ALCOHOL, TOBACCO AND OTHER DRUG USE... 2 ALCOHOL... 3 TOBACCO... 4 MARIJUANA OR HASHISH... 5 INHALANTS... 6 CLUB DRUGS... 6 Ecstasy... 6 Other Club Drugs... 7 OTHER ILLICIT DRUGS... 7 DRUG COMBINATION RATES... 7 Any Illicit Drug... 7 Any Illicit Drug Other than Marijuana... 7 Alcohol Only... 8 Alcohol or Any Illicit Drug... 8 Any Illicit Drug, but No Alcohol...8 OTHER ANTISOCIAL BEHAVIORS... 9 RISK AND PROTECTIVE FACTORS THE SOCIAL DEVELOPMENT STRATEGY MEASUREMENT CHANGES TO THE RISK AND PROTECTIVE FACTOR MEASUREMENT AND SCORING MODEL New Risk and Protective Factor Scales New Normative Data Grade-Level Scoring Trend Analysis USING YOUR RISK AND PROTECTIVE FACTOR DATA Risk and Protective Factor Prioritization Choosing Effective Prevention Strategies SPECIAL TOPICS AGE OF ONSET OF ATOD USE PERCEIVED RISK OF HARM PERSONAL DISAPPROVAL PEER APPROVAL EXTRACURRICULAR ACTIVITIES APPENDIX A: DETAILED TABLES APPENDIX B: REFERENCES APPENDIX C: THE SOCIAL DEVELOPMENT STRATEGY APPENDIX D: OTHER RESOURCES... 39

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9 2006 Florida Youth Substance Abuse Survey Polk County Report T he 2006 Florida Youth Substance Abuse Survey (FYSAS) provides scientifically sound information to communities on the prevalence of alcohol, tobacco and other drug (ATOD) use, and risk and protective factors among 6 th through 12 th grade students. This information is essential to support effective substance abuse needsassessment and services planning, and to measure performance outcomes at local and state levels. This report is one in a series of reports that describes the findings from the FYSAS. As part of the 2006 Florida Youth Survey effort, the FYSAS was administered to Florida youth jointly with the Florida Youth Tobacco Survey in May of The Florida Youth Survey effort was a collaboration among the Florida Departments of Health, Education, Children and Families, Juvenile Justice, and the Florida Office of Drug Control. This report was prepared by Rothenbach Research and Consulting, LLC. The FYSAS was previously administered at the county level to Polk County students in (1) December of 1999 and January of 2000, (2) May of 2002 and (3) May of While the survey form has been updated over this period, the majority of the instrument has remained unchanged. As a result, the present report includes both an analysis of current survey results and comparisons with the 2000, 2002 and 2004 survey findings. This report contains only a brief discussion of methodology. More extensive information on survey administration, methodology and statewide findings can be found in the statewide report, available online at: Methodology The sampling strategy was designed to produce survey results that are representative at both the state and county levels, with a minimal margin of error. In Polk County, this method resulted in a sample target of 1,175 middle school students and 1,183 high school students. After invalid responses were removed, valid questionnaires from 883 middle school students and 731 high school students were included in the dataset. This final sample includes 75% of the target middle school sample and 62% of the target high school sample. Validity of Survey Data Five strategies were used to assess the validity of survey responses. Data were eliminated from the analysis for students who (1) reported unrealistically high levels of substance use, (2) reported unrealistically high levels of other antisocial behaviors, (3) reported use of a fictitious drug, (4) reported logically inconsistent patterns of substance use, or (5) answered less than 25% of the questions on the survey. These five strategies have been shown to consistently identify most surveys that were completed in a random fashion, those that were not taken seriously, and/or those that were not valid for other reasons. Weighting In statewide school-based survey projects like the FYSAS, nonrandom variations in participation across grade levels are common. Inconsistencies between the grade-level distribution of the sample and the student population are especially problematic because ATOD use is strongly associated with age. Inconsistencies between the gender-group distribution of the sample and the student population are less common in school-based surveys. This type of inconsistency also has less impact on ATOD and 1

10 risk and protective factor results because most of these variables are not highly correlated with gender. Nevertheless, gender-group sampling inconsistencies can have some negative impact on survey results. In order to generate drug use prevalence estimates and risk and protective factor scale scores that more accurately represent students in Polk County, it is necessary to adjust the grade and gender distributions of the sample to match the population. This is achieved with a statistical technique called weighting. Through this process, responses from grade levels and gender groups that were underrepresented relative to the true population are given more weight in the data analysis, while responses from the grade levels and gender groups that were overrepresented are given less weight. This creates a sample that proportionately matches student enrollments across grade levels. The 2000, 2002 and 2004 Polk County datasets were weighted across grade levels but not gender groups. Additional weights were also applied to the 2000 dataset to help adjust for the earlier administration dates (December and January) that were employed in that survey effort. (See the 2002 FYSAS statewide report for a complete description of the methods used to prepare the 2000 data for analysis.) Confidence Intervals For the full sample of Polk County respondents, the maximum 95% confidence interval estimate ( the margin of error ) is ±3.4 percentage points for prevalence rates approximating 50% (such as alcohol or tobacco). The maximum 95% confidence interval estimate is ±2.0 percentage points for prevalence rates of 10% or lower (such as Ecstasy or cocaine). The level of certainty, in this case 95%, means that 95 out of 100 times the true population value will fall within the range of the confidence interval. For example, if 40% of the sample indicate using alcohol and the confidence interval is ±2.0%, then the population value should fall within a range of 38% to 42%. For subgroup analyses, confidence intervals are larger. Estimates for Polk County middle school students have confidence intervals ranging from ±4.6 percentage points (50% prevalence rates) to ±2.7 percentage points (10% prevalence rates). Estimates for high school students have confidence intervals ranging from ±5.1 percentage points (50% prevalence rates) to ±3.0 percentage points (10% prevalence rates). Also note that the variance estimates used for these confidence interval calculations include a design effect of 2.0 to adjust for the complex design of the 2006 FYSAS sample. Demographics The survey measures a variety of demographic characteristics. The first two data columns of Table 1 (see Appendix A for data tables) describe the demographic profile of the Polk County sample before weights were applied. Please note that some categories do not sum to 100% due to missing values. Despite covering only three out of seven surveyed grades, middle school students constituted slightly more than one half of the sample (54.4% middle school versus 45.0% high school). A slightly higher percentage of the respondents were female (50.4% female versus 46.7% male). White, non-hispanic students represent 50.5% of the sample. The largest minority population is Hispanic/Latino students (17.5%), followed by African American students (15.3%). The rest of the ethnic breakdown ranges from 0.2% for Native Hawaiian/Pacific Islander students to 12.0% for students who indicated Other/Multiple ethnic backgrounds. The second set of data columns in Table 1 presents the demographic profile information for the statewide sample. Alcohol, Tobacco and Other Drug Use Alcohol, tobacco and other drug (ATOD) use is measured by a set of 39 items on the 2006 FYSAS. While most of the survey items are identical to those used in previous waves of the survey, several key changes have been made. Starting in 2001, the survey included items measuring: (a) the use of so-called club drugs such as Ecstasy, GHB, ketamine and Rohypnol, (b) the use of hallucinogenic mushrooms, and (c) the use of amphetamines, including Ritalin and Adderall, without a doctor s orders. In addition, the use of marijuana and the use of hashish were combined into a single item, and the use of LSD and other psychedelics was reworded to read LSD or PCP. Also starting in 2001, a parenthetical mentioning the street names ice and crystal meth was added to the methamphetamine item. Three changes were made to the ATOD section in 2002: (a) a new item measuring the use of 2

11 OxyContin without a doctor s orders, (b) the prescription drug Xanax was added to the list of examples given in the depressants and downers question, and (c) the other narcotics item was replaced by a new question measuring the use of prescription pain relievers without a doctor s orders. On the 2006 questionnaire, OxyContin was removed as an individual item and added to the list of examples included in the prescription pain reliever item. Also, the question for GHB was changed to include a more up-to-date set of slang or street names for the drug. Tables 2 and 3 and Graphs 1 and 2 show the percentage of surveyed Polk County students who reported using ATODs. These results are presented for both lifetime and past-30-day prevalence of use periods. Lifetime prevalence of use (whether the student has ever used the drug) is a good measure of student experimentation. Past-30-day prevalence of use (whether the student has used the drug within the last month) is a good measure of current use. In addition to the standard lifetime and past-30-day prevalence rates for alcohol use, binge drinking behavior (defined as a report of five or more drinks in a row within the past two weeks) is also measured. Comparisons to the statewide results of the 2006 survey are presented in Tables 2 and 3 and Graphs 3 through 8. Trend comparisons to Polk County results from the 2000, 2002 and 2004 surveys are presented in Tables 4 and 5 and Graphs 3 through 6. Alcohol In most communities, alcohol is the drug used by the largest number of adolescents. As Graph 1 shows, this is indeed the case in Polk County. Prevalence of Use. Of the students surveyed in Polk County in 2006, 52.4% have used alcohol on at least one occasion in their lifetimes. This corresponds to a rate of 43.7% among middle school students and 59.4% among high school students. Current use is substantially lower. Overall, 30.3% of surveyed Polk County students reported the use of alcohol in the past 30 days, with grade-cohort averages of 22.7% for middle school students and 36.3% for high school students. Statewide Comparison. As Graph 3 shows, the prevalence of past-30-day alcohol use for 2006 is lower in Polk County compared to the state of Florida as a whole. Overall, 30.3% of surveyed Polk County students reported the use of alcohol in the past 30 days compared to 32.0% of surveyed students statewide. Grade-cohort analysis shows that this overall lower rate of use is due to the lower rate of usage in high school (36.3% for Polk County versus 41.8% statewide). Usage in middle school is actually higher in Polk County than the state as a whole Graph 1 Lifetime use of alcohol, tobacco and other drugs by Polk County youth, Percentage use Alcohol Cigarettes Marijuana or Hashish Smokeless Tobacco Inhalants Rx. Pain Relievers Depressants Mushrooms Cocaine Rx. Amphetamines Ecstasy Methamphetamine LSD or PCP Crack Cocaine Heroin Ketamine Rohypnol Steroids GHB 3

12 Graph 2 Past-30-day use of alcohol, tobacco and other drugs by Polk County youth, Percentage use Alcohol Binge Drinking Cigarettes Marijuana or Hashish Smokeless Tobacco Inhalants Depressants Rx. Pain Relievers Cocaine Rx. Amphetamines LSD or PCP Ecstasy Mushrooms Methamphetamine Heroin Crack Cocaine Rohypnol Steroids GHB Ketamine (22.7% for Polk County versus 19.0% statewide) Trend. In Polk County, between 2000 and 2006, overall past-30-day alcohol use decreased 4.5 percentage points. Among middle school students, use decreased 1.8 percentage points, and among high school students, use decreased 6.9 percentage points. Between 2004 and 2006, the two most recent waves of the Polk County survey, overall past-30-day alcohol use increased 4.3 percentage points. Among middle school students, use increased 1.4 percentage points, and among high school students, use increased 6.3 percentage points. Binge Drinking. Findings on binge drinking (defined as consuming five or more drinks in a row within the past two weeks) are likely to be among the most important findings related to alcohol use (Johnston, O Malley, Bachman & Schulenberg, 2006). In Polk County, 17.2% of surveyed students reported binge drinking, with corresponding rates of 10.1% among middle school students and 22.9% among high school students. While this represents a similar rate of high school binge drinking compared to the state as a whole (23.0%), Polk County middle school students reported a higher rate compared to results from across Florida (8.4%). Percentage use Graph Tobacco This section of the report discusses the prevalence of tobacco use as measured by the 2006 FYSAS. Another survey, the 2006 Florida Youth Tobacco Survey (Florida Department of Health), was administered simultaneously with the 2006 FYSAS, and was specifically tobacco related. That survey is Florida s official source for youth tobacco use information. The information presented in this report is consistent with findings reported in the 2006 Florida Youth Tobacco Survey. Prevalence of Use. Of the students surveyed in Polk County in 2006, 32.4% have used cigarettes on at Past-30-day alcohol use, Polk County and Florida 2006 Overall County 2000 County 2002 County 2004 County 2006 Florida

13 Percentage use Graph Past-30-day cigarette use, Polk County and Florida 2006 Overall County 2000 County 2002 County 2004 County 2006 Florida 2006 least one occasion in their lifetimes. This corresponds to a rate of 27.9% among middle school students and 36.1% among high school students. Current use is substantially lower. Overall, 12.7% of surveyed Polk County students reported the use of cigarettes in the past 30 days, with grade-cohort averages of 8.0% for middle school students and 16.5% for high school students. Statewide Comparison. As Graph 4 shows, the prevalence of past-30-day cigarette use for 2006 is higher in Polk County compared to the state of Florida as a whole. Overall, 12.7% of surveyed Polk County students reported the use of cigarettes in the past 30 days compared to 10.6% of surveyed students statewide. This increased rate of use applies both to middle school (8.0% for Polk County versus 6.0% statewide) and high school (16.5% for Polk County versus 14.1% statewide) grade-cohorts Trend. In Polk County, between 2000 and 2006, overall past-30-day cigarette use decreased 10.6 percentage points. Among middle school students, use decreased 12.2 percentage points, and among high school students, use decreased 9.3 percentage points. Between 2004 and 2006, the two most recent waves of the Polk County survey, overall past-30-day cigarette use decreased 0.1 percentage points. Among middle school students, use decreased 4.6 percentage points, and among high school students, use increased 3.3 percentage points. Percentage use Graph using smokeless tobacco in their lifetimes, with corresponding rates of 13.0% among middle school students and 18.2% among high school students. The overall prevalence for past-30-day use is 7.5%, with corresponding rates of 5.4% among middle school students and 9.0% among high school students. Marijuana or Hashish Prevalence of Use. Of the students surveyed in Polk County in 2006, 20.7% have used marijuana or hashish on at least one occasion in their lifetimes. This corresponds to a rate of 13.4% among middle school students and 26.6% among high school students. Current use is substantially lower. Overall, 9.9% of surveyed Polk County students reported the use of marijuana or hashish in the past 30 days, with grade-cohort averages of 8.2% for middle school students and 11.2% for high school students. Statewide Comparison. As Graph 5 shows, the prevalence of past-30-day marijuana or hashish use for 2006 is lower in Polk County compared to the state of Florida as a whole. Overall, 9.9% of surveyed Polk County students reported the use of marijuana or hashish in the past 30 days compared to 11.4% of surveyed students statewide. Grade-cohort analysis shows that this overall lower rate of use is due to the lower rate of usage in high school (11.2% for Polk County versus 16.0% statewide). Usage in middle school is actually higher in Polk County than the state as a whole (8.2% for Polk County versus 5.2% statewide) Trend. In Polk County, between 2000 and 2006, overall past-30-day marijuana use decreased Past-30-day marijuana or hashish use, Polk County and Florida 2006 Smokeless Tobacco. The prevalence of smokeless tobacco use is substantially lower than cigarette use. Overall, 15.9% of surveyed Polk County students reported 0 Overall County 2000 County 2002 County 2004 County 2006 Florida

14 Percentage use Graph Past-30-day inhalant use, Polk County and Florida 2006 Overall County 2000 County 2002 County 2004 County 2006 Florida percentage points. Among middle school students, use decreased 7.4 percentage points, and among high school students, use decreased 8.1 percentage points. Between 2004 and 2006, the two most recent waves of the Polk County survey, overall past-30-day marijuana use increased 1.1 percentage points. Among middle school students, use decreased 0.3 percentage points, and among high school students, use increased 2.2 percentage points. Inhalants Prevalence of Use. Of the students surveyed in Polk County in 2006, 13.6% have used inhalants on at least one occasion in their lifetimes. This corresponds to a rate of 16.8% among middle school students and 11.1% among high school students. Current use is substantially lower. Overall, 4.8% of surveyed Polk County students reported the use of inhalants in the past 30 days, with grade-cohort averages of 7.9% for middle school students and 2.2% for high school students. Statewide Comparison. As Graph 6 shows, the prevalence of past-30-day inhalant use for 2006 in Polk County is similar to the rate for the state of Florida as a whole. Across all surveyed grades, 4.8% of surveyed Polk County students reported the use of inhalants in the past 30 days compared to 3.9% of surveyed students statewide. Despite this overall similarity, there was a larger usage rate difference in middle school (7.9% for Polk County versus 5.5% statewide). The usage rate in high school was similar to the statewide rate (2.2% for Polk County versus 2.8% statewide). Percentage use Graph Trend. In Polk County, between 2000 and 2006, the overall rate of past-30-day inhalant use did not change. Among middle school students, use increased 1.6 percentage points, and among high school students, use decreased 1.4 percentage points. Between 2004 and 2006, the two most recent waves of the Polk County survey, overall past- 30-day inhalant use increased 0.4 percentage points. Among middle school students, use increased 0.4 percentage points, and among high school students, use increased 0.1 percentage points. Club Drugs Club drugs are a broad category of illicit substances that are classified together because their use started at dance clubs and raves, not because they are of a similar chemical class (like amphetamines). Their use, however, has expanded beyond these settings. For the purpose of the 2006 FYSAS, club drugs include Ecstasy, GHB, ketamine and Rohypnol. Note that this list is not meant to be exclusive, as other drugs are used at clubs and raves. Ecstasy Prevalence of Use. As it is across the state as a whole, Ecstasy is the most commonly used club drug in Polk County. Overall, 4.0% of surveyed Polk County students have used Ecstasy on at least one occasion in their lifetimes. This corresponds to a rate of 2.9% among middle school students and 4.9% among high school students. Current use is substantially lower. Overall, 1.5% of surveyed Polk County students reported the use of Ecstasy in the past 30 days, with grade-cohort averages of 1.4% for middle school students and 1.6% for high school Past-30-day Ecstasy use, Polk County and Florida 2006 Overall County 2002 County 2004 County 2006 Florida

15 students. Statewide Comparison. As Graph 7 shows, the prevalence of past-30-day Ecstasy use for 2006 in Polk County is similar to the rate for the state of Florida as a whole. Across all surveyed grades, 1.5% of surveyed Polk County students reported the use of Ecstasy in the past 30 days compared to 1.2% of surveyed students statewide. This similarity in the rates of use also applies to middle school (1.4% for Polk County versus 0.8% statewide); the high school rate of use is identical in Polk County and Florida statewide Trend. In Polk County, between 2002 and 2006, overall past-30-day Ecstasy use decreased 0.6 percentage points. Among middle school students, use decreased 0.2 percentage points, and among high school students, use decreased 0.9 percentage points. Between 2004 and 2006, the two most recent waves of the Polk County survey, overall past-30-day Ecstasy use increased 0.1 percentage points. Among middle school students, use decreased 0.1 percentage points, and among high school students, use increased 0.3 percentage points. Other Club Drugs The remaining club drugs Rohypnol, GHB and ketamine all have lower levels of use. In 2006, surveyed Polk County students reported overall lifetime prevalence rates for Rohypnol, GHB and ketamine of 1.2%, 0.9% and 1.6%, respectively. The past-30-day use rates for these same drugs were 0.9%, 0.6% and 0.5%, respectively. Very few students are experimenting with or currently using these drugs. Other Illicit Drugs Prevalence of Use. Lifetime prevalence-of-use rates for this group of drugs range from a high of 9.4% for prescription pain relievers to a low of 1.1% for steroids. The prevalence of use within the past 30 days is lower, going from a high of 4.1% for depressants to a low of 0.6% for steroids. Statewide Comparison. On average, lifetime prevalence rates for other illicit drug use in Polk County are similar to those found for the state of Florida as a whole. The two largest differences were for methamphetamine use (3.4% in Polk County versus 2.1% in Florida) and depressant use (7.7% in Polk County versus 6.5% in Florida). Past-30-day prevalence rates are too low to allow a meaningful comparison between the samples. Drug Combination Rates Prevalence-of-use rates for combinations of drugs provide a helpful summary of drug use behavior. Tables 2 and 3 present lifetime and past-30-day prevalence rates for combinations of drugs (the use of one or more drugs from a set of illicit drugs). Illicit drugs are substances that are illegal for adults to use, so they include all drugs on the survey except alcohol, cigarettes and smokeless tobacco. This list includes: marijuana or hashish, inhalants, LSD or PCP, cocaine, crack cocaine, methamphetamine, depressants, heroin and steroids. In order to provide comparability with previous reports, only drugs that were included on all previous waves (2000 through 2006) of the FYSAS were included. Five types of drug combination rates are presented here: Any illicit drug Use of at least one illicit drug Any illicit drug other than marijuana Use of at least one illicit drug other than marijuana Alcohol only The use of alcohol and no illicit drugs Alcohol or any illicit drug Use of alcohol or at least one illicit drug Any illicit drug, but no alcohol Use of at least one illicit drug, without any use of alcohol Statewide comparative data are presented in Tables 2 and 3 and Graph 8. Trend comparisons to Polk County results from the 2000, 2002 and 2004 surveys are presented in Tables 4 and 5. Any Illicit Drug Overall, 29.4% of surveyed Polk County students reported at least one use of any illicit drug in their lifetimes, and 15.0% reported use in the past 30 days. The past-30-day prevalence rate corresponds to 14.0% among middle school students and 15.7% among high school students. As Graph 8 shows, use of any illicit drug in the past 30 days is the same in Polk County and the state of Florida as a whole (15.0%). Any Illicit Drug Other than Marijuana The purpose of this drug combination rate is to provide prevention planners with an overall indicator of so-called hard drug use (Johnston et al., 2006). Overall, 19.6% of surveyed Polk County students reported at least one use of any illicit drug other than marijuana in their lifetimes, and 9.6% reported use in 7

16 Graph 8 Past-30-day drug combination rates for Polk County and Florida Statewide, Percentage use Any illicit drug Any illicit drug other than marijuana Alcohol only Alcohol or any illicit drug Any illicit drug, but no alcohol Polk County Florida Statewide the past 30 days. The past-30-day prevalence rate corresponds to 9.6% among middle school students and 9.5% among high school students. As Graph 8 shows, use of any illicit drug other than marijuana in the past 30 days is higher in Polk County than across the state of Florida as a whole (9.6% for Polk County versus 7.3% statewide). It is important to note that this measure the current use of all illicit drugs other than marijuana combined is less than the past-30-day prevalence of use of alcohol (30.3%), marijuana (9.9%) and cigarettes (12.7%), as well as the prevalence of binge drinking (17.2%). Alcohol Only Overall, 27.0% of surveyed Polk County students reported at least one use of alcohol only the use of alcohol and no illicit drugs in their lifetimes, and 19.5% reported use in the past 30 days. The past-30- day prevalence rate corresponds to 13.7% among middle school students and 24.1% among high school students. As Graph 8 shows, use of alcohol only in the past 30 days is lower in Polk County than across the state of Florida as a whole (19.5% for Polk County versus 20.9% statewide). Alcohol or Any Illicit Drug Alcohol or any illicit drug use is a summary measure that included all drugs from the 2006 survey, with the exception of cigarettes and smokeless tobacco. Overall, 56.0% of surveyed Polk County students reported at least one use of alcohol or any illicit drug in their lifetimes, and 34.2% reported use in the past 30 days. The past-30-day prevalence rate corresponds to 27.7% among middle school students and 39.1% among high school students. As Graph 8 shows, use of alcohol or any illicit drug in the past 30 days is lower in Polk County than across the state of Florida as a whole (34.2% for Polk County versus 35.4% statewide). Any Illicit Drug, but No Alcohol The final drug combination category measures the use of illicit drugs by students who are not using alcohol. As Tables 2 through 5 show, this combination is quite rare. Overall, 4.0% of surveyed Polk County students reported having used illicit drugs in their lifetimes but never using alcohol. Current use of illicit drugs (within the past 30 days) without the accompanying use of alcohol is also rare (4.3%). The past-30-day prevalence rate corresponds to 5.2% among middle school students and 3.5% among high school students. As Graph 8 shows, use of any illicit drug, but no alcohol in the past 30 days is similar in Polk County and the state (4.3% for Polk County versus 3.7% statewide). 8

17 Other Antisocial Behaviors The 2006 FYSAS also measures a series of eight other problem or antisocial behaviors that is, behaviors that run counter to established norms of good behavior. Note that information on antisocial behaviors is collected only for a prevalence period of the past 12 months. The survey measured the following antisocial behaviors: Carrying a Handgun, Selling Drugs, Attempting to Steal a Vehicle, Being Arrested, Taking a Handgun to, Getting Suspended, Attacking Someone with Intent to Harm and Being Drunk or at. Prevalence rates for these behaviors among Polk County students, as well as comparison rates from the statewide survey, are presented in Table 6 and Graph 9. Trend comparisons to Polk County results from 2000, 2002 and 2004 surveys are presented in Table 12. As Table 6 shows, the prevalence rates reported by Polk County students differ substantially across the eight antisocial behaviors measured in the survey. Reports of Taking a Handgun to (1.3%), Attempting to Steal a Vehicle (3.3%), and Carrying a Handgun (5.8%) are rare, while Getting Suspended (20.3%), Attacking Someone with Intent to Harm (13.0%), and Being Drunk or at (12.7%) are more common. Carrying a Handgun. In Polk County, 5.8% of students reported carrying a handgun in the past year, with rates of 6.1% and 5.6% for middle school and high school students, respectively. Male students (9.2%) were more likely than female students (2.3%) to have reported this behavior. Across the state as a whole, 5.2% of students reported carrying a handgun. Selling Drugs. In Polk County, 6.4% of students reported selling drugs in the past year, with rates of 4.9% and 7.5% for middle school and high school students, respectively. Male students (8.7%) were more likely than female students (4.2%) to have reported this behavior. Across the state as a whole, 5.8% of students reported selling drugs. Attempting to Steal a Vehicle. In Polk County, 3.3% of students reported attempting to steal a vehicle in the past year, with rates of 3.6% and 3.2% for middle school and high school students, respectively. Male students (4.5%) were more likely than female students (2.1%) to have reported this behavior. Across the state as a whole, 3.0% of students reported attempting to steal a vehicle. Being Arrested. In Polk County, 6.4% of students reported being arrested in the past year, with rates of 6.9% and 6.1% for middle school and high school students, respectively. Male students (8.1%) were more likely than female students (4.7%) to have reported this behavior. Across the state as a whole, Graph 9 Comparisons of past-12-month delinquent behavior for Polk County and Florida Statewide, Percentage Getting suspended Attacking with intent to harm Being drunk or high at school Being arrested Selling drugs Carrying a handgun Attempting to steal a vehicle Taking a handgun to school 1.1 Polk County Florida Statewide 9

18 5.5% of students reported being arrested. Taking a Handgun to. In Polk County, 1.3% of students reported taking a handgun to school in the past year. There was no difference in prevalence across grade cohorts, with both middle school and high school students reporting rates of 1.3%. Male students (1.6%) and female students (0.8%) reported similar rates for this behavior. Across the state as a whole, 1.1% of students reported taking a handgun to school. Getting Suspended. In Polk County, 20.3% of students reported getting suspended in the past year, with rates of 25.0% and 16.9% for middle school and high school students, respectively. Male students (22.5%) were more likely than female students (17.5%) to have reported this behavior. Across the state as a whole, 16.1% of students reported getting suspended. Note, however, that the questionnaire item used to measure Getting Suspended does not define suspension. Rather, it is left to the individual respondent to define. Because suspension policies vary substantially from county to county, comparisons to statewide results should be interpreted with caution for this item. Attacking Someone with Intent to Harm. In Polk County, 13.0% of students reported attacking someone with intent to harm in the past year, with rates of 16.0% and 10.8% for middle school and high school students, respectively. Male students (16.1%) were more likely than female students (10.0%) to have reported this behavior. Across the state as a whole, 13.3% of students reported attacking someone with intent to harm. Being Drunk or at. In Polk County, 12.7% of students reported being drunk or high at school in the past year, with rates of 12.1% and 13.3% for middle school and high school students, respectively. Male students (13.2%) and female students (12.2%) reported similar rates for this behavior. Across the state as a whole, 13.0% of students reported being drunk or high at school. Risk and Protective Factors Just as smoking is a risk factor for heart disease and getting regular exercise is a protective factor against heart disease and other health problems, there are factors that can help protect youth from, or put them at risk for, drug use and other problem behaviors. Protective factors, also known as assets, are conditions that buffer children and youth from exposure to risk by either reducing the impact of the risks or changing the way that young people respond to risks. Risk factors are conditions that increase the likelihood of a young person becoming involved in drug use, delinquency, school dropout and/or violence. For example, children living in families with poor family supervision are more likely to become involved in these problems. Research during the past 30 years supports the view that delinquency; alcohol, tobacco and other drug use; school achievement; and other important outcomes in adolescence are associated with specific risk and protective factors in the student s community, school and family environments, as well as with characteristics of the individual (Hawkins, Catalano & Miller, 1992). In fact, these risk and protective factors have been shown to be more important in understanding these behaviors than ethnicity, income or family structure (Blum et al., 2000). There is a substantial amount of research showing that adolescents exposure to a greater number of risk factors is associated with more drug use and delinquency. There is also evidence that exposure to a number of protective factors is associated with lower prevalence of these problem behaviors (Bry, McKeon & Pandina, 1982; Newcomb, Maddahian & Skager, 1987; Newcomb & Felix-Ortiz, 1992; Newcomb, 1995; Pollard et al., 1999). The Social Development Strategy The Social Development Strategy (Hawkins, Catalano & Associates, 1992) organizes these risk and protective factors into a framework that families, schools and communities can use to help children develop healthy behaviors. This strategy, which is graphically depicted in Appendix C, shows how three broad categories of protective factors healthy beliefs and clear standards, bonding, and individual characteristics work together to promote positive youth development and healthy behaviors (Hawkins, Arthur & Catalano, 1995). The Social Development Strategy begins with a goal of healthy behaviors for all children and youth. In order for young people to develop healthy behaviors, adults must communicate healthy beliefs and clear standards for behavior to young people (Catalano & Hawkins, 1996). Bonding (an attached, committed relationship) between a child and an adult who communicates healthy beliefs and 10

19 Graph 10 school protective factor scales for Polk County, 2006 Community Opportunities for Prosocial Involvement 34 Community Rewards for Prosocial Involvement Family Attachment Family Opportunities for Prosocial Involvement Family Rewards for Prosocial Involvement Opportunities for Prosocial Involvement 36 Rewards for Prosocial Involvement 43 Religiosity 50 Social Skills Belief in the Moral Order Community Domain Family Domain Domain Peer and Individual Domain clear standards motivates the child to follow healthy beliefs and clear standards. A child who forges a bond with an adult is less likely to threaten the relationship by violating the beliefs and standards held by the adult. Research has identified three conditions for bonding (Catalano & Hawkins, 1996): First, children need developmentally appropriate opportunities for meaningful involvement with a positive social group (community, family, school, etc.) or individual. Second, children need the emotional, cognitive, social and behavioral skills to successfully take advantage of opportunities. Third, children must be recognized for their involvement. Recognition sets up a reinforcing cycle in which children continue to look for opportunities and learn skills and, therefore, receive recognition. Certain characteristics with which some children come into the world (positive social orientation, resilient temperament and high intelligence) can also help protect children from risk. For children who do not have the protective advantages of these characteristics, in order to build strong bonds to family, school and community, it is even more important for community members to: make extra efforts to provide opportunities for involvement teach the social, emotional, and cognitive skills needed to be successful recognize children s efforts as well as their successes. The developmental process outlined in this model has important implications for prevention planning. Programs that seek to change the attitudes young people hold about the pros and cons of ATOD use, for example, may produce an immediate reduction in the prevalence of problem behaviors. The effectiveness of these efforts will be limited, however, by the risk and protective factors that underlie the acquisition of healthy beliefs and clear standards. If young people have weak bonds to prosocial groups and strong bonds to antisocial groups, they will be less receptive to drug abuse prevention messages. An alternative prevention strategy might involve targeting the risk and protective factors that operate 11

20 at an earlier point in the developmental process. While programs and policies that increase the opportunities for prosocial involvement in the family, at school and in the community may not yield an immediate reduction in the rates of ATOD use, they will encourage young people to form attachments to sources of positive social influence, thereby building the foundation for healthy behavioral choices in the future. Measurement The FYSAS measures a variety of risk and protective factor scales across four domains: Community Domain, Family Domain, Domain, and Peer and Individual Domain. Percentile scores for the 23 risk factor and 10 protective factor scales for middle school and high school grade cohorts are presented in Graphs 10 through 13. Comparisons between the survey results for Polk County and the state of Florida as a whole are presented in Tables 14 and 15. Results for the overall Polk County sample and comparisons to Polk County results from the 2000, 2002 and 2004 surveys are presented in Table 15. Risk and protective factor scales are scored against the Communities That Care normative database. Like the scoring systems used by many national testing programs such as the SAT and ACT this method of norm-referencing generates percentile scores ranging from 0 to 100. A score of 50, which matches the normative median, indicates that 50% of the respondents in the normative sample reported a score that is lower than the average for Florida and 50% reported a score that is higher. Similarly, a score of 75 indicates that 75% of the normative sample reported a lower score and 25% reported a higher score. Because risk is associated with negative behavioral outcomes, it is better to have lower risk factor scale scores, not higher. Conversely, because protective factors are associated with better behavioral outcomes, it is better to have higher protective factor scale scores, not lower. Changes to the Risk and Protective Factor Measurement and Scoring Model Beginning with the 2005 FYSAS, risk and protective factor scale scores were calculated using an enhanced measurement and scoring model. These enhancements fall into four categories: (1) updates to several risk and protective factor scales, (2) the introduction of a new normative database, (3) changes to grade-level scoring and (4) trend analysis. New Risk and Protective Factor Scales 1. The risk factor scale Perceived Availability of Drugs and Handguns has been divided into two independent scales: Perceived Availability of Drugs and Perceived Availability of Handguns. This change improves the utility of prevention data by creating separate measures for two distinct risk factors. 2. The risk factor scale Laws and Norms Favorable to Drug Use and Handguns has also been divided into two independent scales: Laws and Norms Favorable to Drug Use and Laws and Norms Favorable to Handguns. This change improves the utility of prevention data by creating separate measures for two distinct risk factors. 3. The other antisocial behavior components of the risk factor scale Early Initiation (of Drug Use and Antisocial Behavior) have been removed, and the scale has been renamed Early Initiation of Drug Use. This change improves both the reliability of the measure and its utility for prevention planning. 4. The risk factor scales Poor Family Supervision and Poor Family Discipline have been combined into a single scale called Poor Family Management. Analysis of Communities That Care Youth Survey data showed that the items that constitute the two scales are highly correlated across scales. This indicates that the items are more effective at representing a single dimension of family life. 5. The risk factor scale Personal Transitions and Mobility has been renamed Transitions and Mobility. The survey items constituting this scale remain unchanged. 6. The risk factor scale Family Conflict has been added. 7. The protective factor scale Community Opportunities for Prosocial Involvement has been added. New Normative Data The new Communities That Care normative database contains survey responses from over 280,000 students in grades 6 through 12. It was compiled by combining the results of selected Communities That Care Youth Survey efforts that were completed in 2000, 2001 and To enhance representativeness, 12

21 statistical weights were applied to adjust the sample to exactly match the population of U.S. public school students on four key demographic variables: ethnicity, sex, socioeconomic status and urbanicity. Information on the U.S. public school student population was obtained from the Common Core of Data program at the U.S. Department of Education s National Center for Education Statistics. Grade-Level Scoring In previous FYSAS efforts, risk and protective factor scale scores were calculated by comparing all respondents against a combined normative sample of students in grades 6, 8, 10, and 12. Because it contains a large number of respondents within each of the survey s seven grade levels, the new Communities That Care normative database allows the comparisons to be done on a grade-by-grade basis. This means that 6 th graders who take the FYSAS will only be compared with 6 th grade responses in the normative database, 7 th graders will only be compared with 7 th grade responses, and so on. Grade-level comparisons improve the accuracy of norm-referenced scores. Overall percentile scores for risk and protective factor scales are created by weighting the Communities That Care normative database to match the grade-level distribution of the FYSAS sample. Trend Analysis Risk and protective factor scale scores generated with the new measurement and scoring model are not directly comparable to scores generated with the previous model. As a result, overall scores from the 2000, 2002 and 2004 FYSAS have been recalculated using the new methodology in order to support trend analysis. These results are presented in Table 15. Using Your Risk and Protective Factor Data The analysis of risk and protective factors is the most powerful tool available for understanding what promotes both positive and negative adolescent behavior and for helping design successful prevention programs for young people. To promote positive development and prevent problem behavior, it is necessary to address the factors that predict these outcomes. By measuring these risk and protective factors, specific factors that are elevated can be prioritized in the community. This process also helps in selecting tested-effective prevention programming shown to address those elevated factors and consequently provide the greatest likelihood for success. Risk and Protective Factor Prioritization In general, a prevention strategy that focuses on a relatively narrow set of developmental factors can be more effective than a strategy that spreads resources across a broad set of factors. Risk and protective factor data from the FYSAS can provide critical guidance in this prioritization process. That is, prevention planners can use the information gathered by the survey to identify youth development areas where programs, policies and practices are likely to have the greatest positive impact. Start the prioritization process by identifying the protective factor scales with the lowest percentile scores and the risk factor scales with the highest percentile scores. Because of the smaller number of protective factor scales compared to the number of risk factor scales, protective factors should be prioritized across domains while risk factors should be prioritized within domains. Conduct this analysis separately for students in middle school and students in high school. This is necessary because risk and protective factor profiles can change as students get older, and because many prevention programs target specific stages of youth development. 13

22 Lowest Protective Factor Scales Across all 10 protective factor scales, both middle school and high school students in Polk County reported the lowest level of protection for the Community Opportunities for Prosocial Involvement scale. school students scored a 34, three points lower than the statewide average of 37. school students scored a 38, equaling the statewide average. Students who reported low scores on this scale have fewer opportunities to interact closely with positive adult role models in their neighborhoods and to participate in sports, clubs and other prosocial community activities. As a result, these students are less likely to form strong community bonds that encourage the adoption of prosocial norms and values. Polk County middle school students also reported low levels of protection for two other scales. The first of these was Belief in the Moral Order. Their score of 36 was three points lower than the statewide average of 39. Low scores on this scale indicate that students are less likely to accept commonly held beliefs about what constitutes appropriate and inappropriate behavior. When students reject basic social values they may be more likely to engage in ATOD use and other forms of delinquent behavior. The second additional protective factor scale with a low score in middle school was Opportunities for Prosocial Involvement. Their score of 36 was four points lower than the statewide average of 40. Students with low scores on this scale have fewer opportunities to interact closely with teachers, get involved with special projects and activities in the classroom, Graph 11 school risk factor scales for Polk County, 2006 Low Neighborhood Attachment Community Disorganization Transitions and Mobility Laws and Norms Favorable to Drug Use Laws and Norms Favorable to Handguns Perceived Availability of Drugs Perceived Availability of Handguns Poor Family Management Family Conflict Family History of Antisocial Behavior Parental Attitudes Favorable toward ATOD Use Parental Attitudes Favorable toward Antisocial Behavior Poor Academic Performance Lack of Commitment to Rebelliousness Friends Delinquent Behavior Friends Use of Drugs Peer Rewards for Antisocial Behavior Favorable Attitudes toward Antisocial Behavior Favorable Attitudes toward ATOD Use Low Perceived Risks of Drug Use Early Initiation of Drug Use Sensation Seeking Community Domain Family Domain Domain Peer and Individual Domain 14

23 and participate in sports, clubs and other school activities outside of the classroom. This lack of involvement deprives students of the opportunity to form healthy relationships with teachers and prosocial peers. school students in Polk County reported a low level of protection for the Family Rewards for Prosocial Involvement scale. Their score of 41 was seven points lower than the statewide average of 48. Students who reported low scores on this scale are less likely to receive praise and support from their parents when they accomplish something positive. This lack of feedback, in turn, may weaken the parent-child bond and inhibit the ability of parents to transfer prosocial values to their children. est Risk Factor Scales Community Domain: Within the Community Domain, both middle school and high school students in Polk County reported the highest level of risk for the Transitions and Mobility scale. school students scored a 66, two points higher than the statewide average of 64. school students scored a 67, two points higher than the statewide average of 65. scores on this scale indicate that students are changing homes and schools more frequently. Dislocations of this type can inhibit the ability of young people to become involved with prosocial organizations and individuals within their school and community. Family Domain: Within the Family Domain, both middle school and high school students in Polk County reported the highest level of risk for the Poor Family Management scale. school students scored a 62, three points higher than the statewide average of 59. school students scored a 62, six points higher than the statewide average of 56. Students with high scores on this scale live in families in which child supervision is a lower priority. Parents in these families place less emphasis on making sure homework is completed on time, monitoring children s activities outside of the home, and setting clear rules about alcohol and drug use. Delinquent behaviors such as drug use, skipping school and carrying a weapon are also less likely to be noticed and punished. Domain: Within the Domain, both middle school and high school students in Polk County reported the highest level of risk for the Lack of Commitment to scale. school students scored a 58, one point higher than the statewide average of 57. school students scored a 48, four points lower than the statewide average of 52. Students with high scores on this scale have negative feelings about school, and are less likely to report that school work is meaningful or important for their future. Young people who have lost this commitment to school are at higher risk for a variety of problem behaviors. Peer and Individual Domain: Within the Peer and Individual Domain, both middle school and high school students in Polk County reported the highest level of risk for the Friends Delinquent Behavior scale. school students scored a 66, six points higher than the statewide average of 60. school students scored a 53, equaling the statewide average. Students with high scores on this scale have a greater number of friends who are involved with antisocial behaviors like selling drugs or carrying a weapon, or who have gotten into trouble with school officials or police. Young people who associate with delinquent peers are more likely to become involved with delinquent behavior themselves. 15

24 Graph 12 school protective factor scales for Polk County, 2006 Community Opportunities for Prosocial Involvement 38 Community Rewards for Prosocial Involvement 49 Family Attachment Family Opportunities for Prosocial Involvement Family Rewards for Prosocial Involvement Opportunities for Prosocial Involvement Rewards for Prosocial Involvement Religiosity Social Skills Belief in the Moral Order Community Domain Family Domain Domain Peer and Individual Domain Strengths to Build on In addition to specifying problem areas, the prioritization process also benefits from identifying the scales for which students reported the highest levels of protection and the lowest levels of risk. These areas represent strengths that Polk County may wish to build on. est Protective Factor Scales: Across all 10 protective factor scales, both middle school and high school students in Polk County reported the highest level of protection for the Religiosity scale. school students scored a 50, three points higher than the statewide average of 47. school students scored a 53, four points higher than the statewide average of 49. Students who reported high scores on this scale attend religious services and activities more frequently. As a result, they are more likely to benefit from relationships with prosocial adults and peers, opportunities for prosocial activities, and the teaching of prosocial values that are often part of religious involvement. Additionally, middle school students in Polk County also reported a high level of protection for the Community Rewards for Prosocial Involvement scale. Their score of 44 was one point lower than the statewide average of 45. Students who reported high scores on this scale receive encouragement and praise from neighbors and other members of their communities. With this type of support, young people may be more likely to accept the guidance available from the positive role models in their communities. school students in Polk County also reported a high level of protection for the Social Skills scale. Their score of 52 was the same as the statewide average. Students with high levels of social skills are better able to resolve conflicts in a productive manner and avoid risky behaviors in favor of more positive, prosocial choices. Lowest Risk Factor Scales: Across all 23 risk factor scales, middle school students in Polk County reported the lowest level of risk for the Poor Academic Performance scale. Their score of 52 was the same as the statewide average. Beginning in the late 16

25 elementary grades, academic success decreases the risk of drug use, delinquency, violence and school dropout. school students reported the lowest levels of risk for four scales. The first of these was Early Initiation of Drug Use. Their score of 42 was three points lower than the statewide average of 45. Low scores on this scale indicate either the absence or postponed initiation of alcohol, cigarette and marijuana use. Young people who experiment with drug use at an earlier age are more likely to engage in frequent use and extend their usage to more dangerous drugs, and are less likely to discontinue use as they enter adulthood. The second risk factor scale with the lowest score in high school was Friends Use of Drugs. Their score of 42 was three points lower than the statewide average of 45. Students with low scores on this scale indicated that few, if any, of their best friends use alcohol, tobacco or other drugs. Young people who do not associate with drug using peers are less likely to use drugs themselves. Research has shown peer influence to be one of the strongest predictors of ATOD use stronger, in many cases, than the influence of parents or other family members. The third risk factor scale with the lowest score in high school was Perceived Availability of Drugs. Their score of 42 was four points lower than the statewide average of 46. A low score on this scale indicates that it is difficult for students to get alcohol, tobacco or other drugs. The fourth risk factor scale with the lowest score in high school was Laws and Norms Favorable to Drug Use. Their score of 42 was three points lower than the statewide average of 45. Students with low scores on this scale believe that adults in their community are likely to disapprove of drug use, and that police are more likely to catch young people who are using drugs. When young people believe that the laws and norms concerning drug use are strictly enforced, they are less likely to engage in dangerous behavior. school students also reported a low level of risk for one other scale, Low Perceived Risks of Drug Use. Their score of 53 was two points higher than the statewide average of 51. Students with low scores on this scale believe that alcohol, cigarette and marijuana use pose a substantial risk. When young people perceive the risk of drug use to be high they are less likely to experiment with these substances. In many communities, beliefs about the risks associated with ATOD use are a leading indicator of future usage patterns. That is, when perceived risk goes up, use often goes down. Alternatively, when perceived risk goes down, use often goes up. Further Considerations In addition to identifying the highest risk factor scales and lowest protective factor scales, the prevention prioritization process may include several supplemental steps, such as: Compare county-level results to state-level results. Risk and protective factor scale scores from the statewide FYSAS are presented in Tables 14 and 15. A comparison to statewide results may reveal additional strengths and weaknesses in Polk County s risk and protective factor profile. For example, a risk factor scale that is not the most elevated within its domain may be designated as a target for prevention programming because it is notably higher in Polk County than across the state as a whole. Review the prevalence of ATOD use and other antisocial behaviors in your community. A high rate of alcohol use, for example, may dictate a different prevention strategy than a high rate of youth violence. The table on the second page in Appendix C provides a resource for this analysis by showing the behavioral outcomes that have been linked, in multiple longitudinal studies, to each risk factor. Use archival data to fill the gaps in the FYSAS data, and to support findings in the survey. For example, Teen Pregnancy and Drop-Out are problem behaviors not measured by the survey that may influence prevention planning. Archival data are information sources that have already been collected and/or documented at the local, state or national level. They can include records that are kept by governmental and other agencies, and records that are normally kept as part of the operation of an institution or organization. Consider which risk and protective factors the community can realistically tackle at this time. Some factors may be too big, or there may be other efforts already underway in the community to address them. If your community does not 17

26 have extensive financial or human resources, then it may be appropriate to narrow the list down to one or two priority factors. Consider political, social and economic factors in the community. What is best for the community? Which risk and protective factors would policy makers find acceptable to address at this time? Choosing Effective Prevention Strategies After completing the prioritization process and identifying key risk and protective factors for focused prevention efforts, the next step for communities is to select research-based, proven-effective programs that target these problem areas. A major breakthrough in the field of positive youth development in the past two decades has been the development and testing of programs, policies and practices that are shown to work to reduce adolescent drug use, violence, risky sexual behavior and school failure. State and national agencies have become increasingly interested in and committed to programs, policies and practices that have been rigorously tested for effectiveness. Prevention strategies identified as tested, effective are those that have been tested in well-controlled trials comparing schools, families, young people or communities that received the strategy with those that did not. Results of those trials showed that those who received the strategies were better off than those that did not, in terms of lower risk, greater protection and better behavioral outcomes. A good first step in the strategy selection process is to review published lists of tested, effective prevention resources. A number of organizations have constructed lists that link research-based Graph 13 school risk factor scales for Polk County, 2006 Low Neighborhood Attachment Community Disorganization Transitions and Mobility Laws and Norms Favorable to Drug Use Laws and Norms Favorable to Handguns Perceived Availability of Drugs Perceived Availability of Handguns Poor Family Management Family Conflict Family History of Antisocial Behavior Parental Attitudes Favorable toward ATOD Use Parental Attitudes Favorable toward Antisocial Behavior Poor Academic Performance Lack of Commitment to Rebelliousness Friends Delinquent Behavior Friends Use of Drugs Peer Rewards for Antisocial Behavior Favorable Attitudes toward Antisocial Behavior Favorable Attitudes toward ATOD Use Low Perceived Risks of Drug Use Early Initiation of Drug Use Sensation Seeking Community Domain Family Domain Domain Peer and Individual Domain 18

27 programs with the risk and protective factors they have been shown to effectively address. Additional information on the four lists presented below is available in Appendix D of this report. The Communities That Care Prevention Strategies Guide The U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration s (SAMHSA) Model Programs list The University of Colorado at Boulder s Blueprints for Violence Prevention initiative, sponsored by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) The Western Center for the Application of Prevention Technologies (CAPT) list of Best Practices and Promising Practices In addition to selecting research-based, proveneffective programs to target areas of low protection and high risk, communities should also consider the impact of environmental factors and public policies. For example, a strategy to combat a high level of Perceived Availability of Drugs might incorporate changes to local laws or provide resources to strengthen the enforcement of existing laws. Special Topics Several analyses were conducted to investigate alcohol, tobacco and other drug (ATOD) use results. These include age of onset of ATOD use and attitudes toward ATOD use (perceived risk of harm, personal disapproval and peer approval). Age of Onset of ATOD Use Students were asked to report on when they began using alcohol, cigarettes and marijuana. Age of onset for these drugs is of special importance, since they are often precursors to the use of harder drugs such as methamphetamine and cocaine. The question related to cigarettes is How old were you when you first smoked a cigarette, even just a puff? The question about marijuana is How old were you when you first smoked marijuana? Two questions about alcohol were asked, one asking when the student first had more than a sip or two of beer, wine or hard liquor (for example, vodka, whiskey or gin) and one asking the student when he or she began drinking alcoholic beverages regularly, that is, at least once or twice a month. Tables 8 and 13 present the average age students reported first engaging in any alcohol use, regular alcohol use, any use of cigarettes, and any use of marijuana. For most items on this survey, averaging the scores of all respondents provides the best overall description of the behavior or attitude under investigation. In contrast, the question When do Florida students first start using ATODs? is best answered by examining the responses of high school students. This is because scores for this question are based only on students who reported engaging in the behavior. Consequently, younger students who will eventually experiment with ATODs as they enter higher grades are excluded from the analysis, resulting in an artificial lowering of age of onset scores. Note that in the statewide report, age of onset of ATOD use is discussed for 12 th graders rather than high school students. The earliest age of onset reported by Polk County s surveyed high school students was for cigarette use (13.0 years of age), followed by more than a sip or two of alcohol (13.3 years of age), marijuana use (14.0 years of age) and drinking at least once a month (14.8 years of age). Perceived Risk of Harm Perception of risk is an important determinant in the decision-making process young people go through when deciding whether or not to use alcohol, tobacco or other drugs. Evidence also suggests that the perceptions of the risks and benefits associated with drug use sometimes serve as a leading indicator of future drug use patterns in a community (Bachman, Johnston, O Malley & Humphrey, 1986). Tables 9 and 13 present prevalence rates for surveyed Polk County students assigning great risk of harm to four drug use behaviors: near daily use of alcohol, daily use of cigarettes, regular use of marijuana, and trying marijuana once or twice. Surveyed Polk County students assigned the highest risk of harm to daily use of cigarettes (63.3%), followed by regular use of marijuana (62.7%), near daily use of alcohol (40.9%) and trying marijuana once or twice (35.4%). Daily Use of Alcohol. In Polk County, 40.9% of students reported that having one or more drinks nearly every day would pose a great risk of harm. This is down 1.9 percentage points from school students reported a rate of 39.9% and high school students reported a rate of 41.8%. Across the state as a whole, 40.0% of students reported that 19

28 near daily use of alcohol would pose a great risk of harm. Daily Use of Cigarettes. In Polk County, 63.3% of students reported that smoking a pack or more of cigarettes every day would pose a great risk of harm. This is down 2.5 percentage points from school students reported a rate of 61.0% and high school students reported a rate of 65.3%. Across the state as a whole, 66.0% of students reported that near daily use of cigarettes would pose a great risk of harm. Regular Use of Marijuana. In Polk County, 62.7% of students reported that smoking marijuana regularly would pose a great risk of harm. This is down 3.1 percentage points from school students reported a rate of 70.2% and high school students reported a rate of 56.7%. Across the state as a whole, 60.4% of students reported that smoking marijuana regularly would pose a great risk of harm. Trying Marijuana Once or Twice. In Polk County, 35.4% of students reported that trying marijuana once or twice would pose a great risk of harm. This is down 0.8 percentage points from school students reported a rate of 41.7% and high school students reported a rate of 30.1%. Across the state as a whole, 32.6% of students reported trying marijuana once or twice would pose a great risk of harm. Personal Disapproval In addition to perceptions of risk, personal approval or disapproval of drugs has been linked to the prevalence of ATOD use (Bachman, Johnston & O Malley, 1996). Personal disapproval was measured by asking students how wrong it would be for someone their age to drink alcohol regularly, smoke cigarettes, smoke marijuana, or use other illicit drugs ( LSD, cocaine, amphetamines or another illegal drug ). The rates presented in Tables 9 and 13 represent the percentages of students who thought it would be wrong or very wrong to use each drug. Surveyed Polk County students were most likely to disapprove of other illicit drug use (93.9%), followed by smoking marijuana (82.7%), smoking cigarettes (76.9%) and drinking alcohol regularly (65.5%). Smoking Cigarettes. In Polk County, 76.9% of students reported that they think it would be wrong or very wrong for someone their age to smoke cigarettes. This is up 10.1 percentage points from school students reported a rate of 84.6% and high school students reported a rate of 70.6%. Across the state as a whole, 78.8% of students reported disapproval of smoking cigarettes. Drinking Alcohol Regularly. In Polk County, 65.5% of students reported that they think it would be wrong or very wrong for someone their age to drink alcohol regularly. This is up 2.6 percentage points from school students reported a rate of 76.0% and high school students reported a rate of 56.7%. Across the state as a whole, 63.6% of students reported disapproval of drinking alcohol regularly. Smoking Marijuana. In Polk County, 82.7% of students reported that they think it would be wrong or very wrong for someone their age to smoke marijuana. This is up 5.6 percentage points from school students reported a rate of 88.0% and high school students reported a rate of 78.3%. Across the state as a whole, 80.4% of students reported disapproval of smoking marijuana. Using Other Illicit Drugs. In Polk County, 93.9% of students reported that they think it would be wrong or very wrong for someone their age to use other illicit drugs. This is up 0.2 percentage points from school students reported a rate of 95.3% and high school students reported a rate of 92.7%. Across the state as a whole, 95.0% of students reported disapproval of using other illicit drugs. Peer Approval In addition to perceived risk of harm and disapproval, expectations of how one s peer group might react have an impact on whether or not young people choose to use drugs. The data presented in Tables 10 and 13 show the percentage of students who said that there is a pretty good or very good chance that they would be seen as cool if they smoked cigarettes, drank alcohol regularly or smoked marijuana. Drinking Alcohol Regularly. In Polk County, 12.9% of students reported that there is a pretty good or a very good chance that they would be seen as cool if they drank alcohol regularly. Students reported the same rate in school students reported a rate of 10.7% and high school students reported a rate of 14.7%. Across the state as a whole, 13.1% of students reported peer approval of drinking alcohol regularly. Smoking Cigarettes. In Polk County, 6.4% of students reported that there is a pretty good or a very good chance that they would be seen as cool if they smoked cigarettes. This is down 1.6 percentage points from school students reported a 20

29 rate of 8.1% and high school students reported a rate of 5.0%. Across the state as a whole, 6.0% of students reported peer approval of smoking cigarettes. Smoking Marijuana. In Polk County, 11.3% of students reported that there is a pretty good or a very good chance that they would be seen as cool if they smoked marijuana. This is down 1.3 percentage points from school students reported a rate of 11.9% and high school students reported a rate of 10.9%. Across the state as a whole, 11.5% of students reported peer approval of smoking marijuana. Clubs. In Polk County, 30.8% of students reported participation in school clubs. school students participated at a rate of 26.8% and high school students participated at a rate of 34.1%. Across the state as a whole, the rate of participation was 25.8%. Community Clubs. In Polk County, 10.7% of students reported participation in community clubs. school students participated at a rate of 9.3% and high school students participated at a rate of 11.9%. Across the state as a whole, the rate of participation was 12.3%. Extracurricular Activities In 2006 a new item was added to the FYSAS questionnaire that measures participation in five extracurricular activities: school sports, organized sports outside of school, school band, school clubs, and community clubs. Results for these items are presented in Table 11. Participation in these activities help students build stronger ties to their school and community. Through these connections students are also more likely to develop attachments to prosocial peers and to positive adult role models. Since these bonds encourage students to engage in developmentally positive activity, they serve as a buffer against ATOD use and other antisocial behaviors. Please note that this measure is similar to two of the protective factor scales discussed earlier in this report: Community Opportunities for Prosocial Involvement and Opportunities for Prosocial Involvement. Sports. In Polk County, 34.2% of students reported participation in school sports. school students participated at a rate of 27.5% and high school students participated at a rate of 39.8%. Across the state as a whole, the rate of participation was 35.8%. Organized Sports Outside of. In Polk County, 31.4% of students reported participation in organized sports outside of school. school students participated at a rate of 42.9% and high school students participated at a rate of 22.2%. Across the state as a whole, the rate of participation was 33.2%. Band. In Polk County, 11.0% of students reported participation in school band. school students participated at a rate of 15.1% and high school students participated at a rate of 7.7%. Across the state as a whole, the rate of participation was 10.2%. 21

30

31 Appendix A Detailed Tables Appendix A: Detailed Tables 23

32 Table 1. Major demographic characteristics of surveyed Polk County youth and Florida Statewide youth Polk County Florida Statewide N % N % Sex Female , Male , Race/Ethnic group African American , American Indian Asian , Hispanic/Latino , Native Hawaiian/Pacific Islander Other/Multiple , White, non-hispanic , Age , , , , , , , , or older Grade 6th , th , th , th , th , th , th , Overall , Overall , Total 1, , Note: Some categories do not sum to 100% of the total due to missing values (e.g., not all survey questions were answered). In addition, rounding can produce totals that do not equal 100%. N represents the number of valid cases. 24

33 Table 2. Percentages of Polk County youth and Florida Statewide youth who reported having used various drugs in their lifetimes Female Polk County Male Total Female Florida Statewide Male Total Alcohol Cigarettes Smokeless Tobacco Marijuana or Hashish Inhalants Ecstasy Rohypnol LSD or PCP Hallucinogenic Mushrooms GHB Ketamine Methamphetamine Cocaine Crack Cocaine Depressants Heroin Prescription Pain Relievers Prescription Amphetamines Steroids Any illicit drug Any illicit drug other than marijuana Alcohol only Alcohol or any illicit drug Any illicit drug, but no alcohol Note: In order to provide comparability with previous reports, only drugs that were included in all previous waves of the FYSAS were included in the drug combination rates. 25

34 Table 3. Percentages of Polk County youth and Florida Statewide youth who reported having used various drugs in the past 30 days Female Polk County Male Total Female Florida Statewide Male Total Alcohol Binge Drinking Cigarettes Smokeless Tobacco Marijuana or Hashish Inhalants Ecstasy Rohypnol LSD or PCP Hallucinogenic Mushrooms GHB Ketamine Methamphetamine Cocaine Crack Cocaine Depressants Heroin Prescription Pain Relievers Prescription Amphetamines Steroids Any illicit drug Any illicit drug other than marijuana Alcohol only Alcohol or any illicit drug Any illicit drug, but no alcohol Note: In order to provide comparability with previous reports, only drugs that were included in all previous waves of the FYSAS were included in the drug combination rates. 26

35 Table 4. Lifetime trend in alcohol, tobacco and other drug use for Polk County youth, 2000, 2002, 2004 and Total Alcohol Cigarettes Smokeless Tobacco Marijuana or Hashish Inhalants Ecstasy Rohypnol LSD or PCP Hallucinogenic Mushrooms GHB Ketamine Methamphetamine Cocaine Crack Cocaine Depressants Heroin Prescription Pain Relievers Prescription Amphetamines Steroids Any illicit drug Any illicit drug other than marijuana Alcohol only Alcohol or any illicit drug Any illicit drug, but no alcohol Note: The symbol -- indicates that data are not available. 1 Measured as LSD or other psychedelics in the 2000 survey, and as LSD or PCP in the 2002, 2004 and 2006 surveys. 2 In 2006, the question for GHB was changed to include a more up-to-date set of slang or street names for the drug. 3 In 2002, the prescription drug Xanax was added to the list of examples given in the depressants question. Total 4 In 2006, OxyContin was removed as an individual item and added to the list of examples included in the prescription pain relievers item. 5 In order to provide comparability with previous reports, only drugs that were included in all previous waves of the FYSAS were used in the drug combination rates. Total Total 27

36 Table 5. Past-30-day trend in alcohol, tobacco and other drug use for Polk County youth, 2000, 2002, 2004 and Total Alcohol Binge Drinking Cigarettes Smokeless Tobacco Marijuana or Hashish Inhalants Ecstasy Rohypnol LSD or PCP Hallucinogenic Mushrooms GHB Ketamine Methamphetamine Cocaine Crack Cocaine Depressants Heroin Prescription Pain Relievers Prescription Amphetamines Steroids Any illicit drug Any illicit drug other than marijuana Alcohol only Alcohol or any illicit drug Any illicit drug, but no alcohol Note: The symbol -- indicates that data are not available. 1 Measured as LSD or other psychedelics in the 2000 survey, and as LSD or PCP in the 2002, 2004 and 2006 surveys. 2 In 2006, the question for GHB was changed to include a more up-to-date set of slang or street names for the drug. 3 In 2002, the prescription drug Xanax was added to the list of examples given in the depressants question. Total 4 In 2006, OxyContin was removed as an individual item and added to the list of examples included in the prescription pain relievers item. 5 In order to provide comparability with previous reports, only drugs that were included in all previous waves of the FYSAS were used in the drug combination rates. Total Total 28

37 Table 6. Percentages of Polk County youth and Florida Statewide youth who reported engaging in delinquent behavior within the past 12 months Female Polk County Male Total Female Florida Statewide Male Total Carrying a handgun Selling drugs Attempting to steal a vehicle Being arrested Taking a handgun to school Getting suspended Attacking someone with intent to harm Being drunk or high at school Table 7. Percentages of Polk County youth and Florida Statewide youth who reported gambling and arguing about gambling in the past 12 months Polk County Florida Statewide Female Male Total Female Male Total Gambling Arguing about gambling

38 Table 8. Mean age of first substance use among Polk County youth and Florida Statewide youth Polk County Florida Statewide Mean Age At First Use Female Male Total Female Male Total More than a sip of alcohol Drinking at least once a month Cigarettes Marijuana Table 9. Percentages of Polk County youth and Florida Statewide youth who reported a perceived risk of harm or personal disapproval Female Polk County Male Total Female Florida Statewide Male Total Perceive great risk of harm if One or more drinks every day Smoke a pack or more every day Smoke marijuana regularly Try marijuana once or twice Think it would be wrong for someone their age to Smoke cigarettes Drink alcohol regularly Smoke marijuana Use other illicit drugs

39 Table 10. Percentages of Polk County youth and Florida Statewide youth who reported peer approval Female Polk County Male Total Female Florida Statewide Male Total Good chance of being seen as cool if Drink alcohol regularly Smoke cigarettes Smoke marijuana Table 11. Percentages of Polk County youth and Florida Statewide youth who reported participation in extracurricular activities Female Polk County Male Total Female Florida Statewide Male Total Sports Organized Sports Outside of Band Club(s) Community Club(s) Table 12. Trends in delinquent behaviors for Polk County youth, 2000, 2002, 2004 and Total Carrying a handgun Selling drugs Attempting to steal a vehicle Being arrested Taking a handgun to school Getting suspended Attacking someone with intent to harm Being drunk or high at school Total Total Total 31

40 Table 13. Trends in mean age of first use and attitudes toward substance use for Polk County youth, 2000, 2002, 2004 and Total Age when first used More than a sip or two of alcohol Drinking at least once a month Cigarettes Marijuana Perceive great risk of harm if One or more drinks every day Smoke a pack or more every day Smoke marijuana regularly Try marijuana once or twice Think it wrong if Smoke cigarettes Drink alcohol regularly Smoke marijuana Use other illicit drugs Seen as cool if Drink alcohol regularly Smoke cigarettes Smoke marijuana Total Total Total 32

41 Table 14. Protective and risk factor scale scores for Polk County youth and Florida Statewide youth by grade-cohort, 2006 Protective Factors Domain Scale Polk County Florida Statewide Community Community Opportunities for Prosocial Involvement Community Rewards for Prosocial Involvement Family Family Attachment Family Opportunities for Prosocial Involvement Family Rewards for Prosocial Involvement Opportunities for Prosocial Involvement Rewards for Prosocial Involvement Peer and Religiosity Individual Social Skills Belief in the Moral Order Average Protective Factor Scale Score Risk Factors Domain Scale Polk County Florida Statewide Community Low Neighborhood Attachment Community Disorganization Transitions and Mobility Laws and Norms Favorable to Drug Use Laws and Norms Favorable to Handguns Perceived Availability of Drugs Perceived Availability of Handguns Family Poor Family Management Family Conflict Family History of Antisocial Behavior Parental Attitudes Favorable toward ATOD Use Parental Attitudes Favorable toward Antisocial Behavior Poor Academic Performance Lack of Commitment to Peer and Individual Rebelliousness Friends Delinquent Behavior Friends Use of Drugs Peer Rewards for Antisocial Behavior Favorable Attitudes toward Antisocial Behavior Favorable Attitudes toward ATOD Use Low Perceived Risks of Drug Use Early Initiation of Drug Use Sensation Seeking Average Risk Factor Scale Score Note: A score of 50 indicates the average for the normative population, with scores higher than 50 indicating above-average scores, and scores below 50 indicating below-average scores. Because risk is associated with negative behavioral outcomes, it is better to have lower risk factor scale scores, not higher. Conversely, because protective factors are associated with better student behavioral outcomes, it is better to have protective factor scale scores with high values. 33

42 Table 15. Overall trends in overall protective and risk factor scale scores for Polk County youth, 2000, 2002, 2004 and 2006 and Florida Statewide youth, 2006 Protective Factors Domain Scale Polk County Florida Community Community Opportunities for Prosocial Involvement Community Rewards for Prosocial Involvement Family Family Attachment Family Opportunities for Prosocial Involvement Family Rewards for Prosocial Involvement Opportunities for Prosocial Involvement Rewards for Prosocial Involvement Peer and Religiosity Individual Social Skills Belief in the Moral Order Average Protective Factor Scale Score Risk Factors Domain Scale Polk County Florida Community Low Neighborhood Attachment Community Disorganization Transitions and Mobility Laws and Norms Favorable to Drug Use Laws and Norms Favorable to Handguns Perceived Availability of Drugs Perceived Availability of Handguns Family Poor Family Management Family Conflict Family History of Antisocial Behavior Parental Attitudes Favorable toward ATOD Use Parental Attitudes Favorable toward Antisocial Behavior Poor Academic Performance Lack of Commitment to Peer and Individual Rebelliousness Friends Delinquent Behavior Friends Use of Drugs Peer Rewards for Antisocial Behavior Favorable Attitudes toward Antisocial Behavior Favorable Attitudes toward ATOD Use Low Perceived Risks of Drug Use Early Initiation of Drug Use Sensation Seeking Average Risk Factor Scale Score Note: A score of 50 indicates the average for the normative population, with scores higher than 50 indicating above-average scores, and scores below 50 indicating below-average scores. Because risk is associated with negative behavioral outcomes, it is better to have lower risk factor scale scores, not higher. Conversely, because protective factors are associated with better student behavioral outcomes, it is better to have protective factor scale scores with high values. 34

43 Appendix B References Appendix B: References Arthur, M. W., Hawkins, J. D., Pollard, J. A., Catalano, R. F. & Baglioni, A. J. (2002). Measuring risk and protective factors for substance use, delinquency, and other adolescent problem behaviors: The communities that care youth survey. Evaluation Review, 26, Bachman, J. G., Johnston, L. D. & O Malley, P. M. (1996). The Monitoring the Future project after twenty-two years: Design and procedures. (Monitoring the Future Occasional Paper No. 38.) Ann Arbor, MI: Institute for Social Research. Bachman, J. G., Johnston, L. D., O Malley, P. M. & Humphrey, R. H. (1986). Changes in marijuana use linked to changes in perceived risks and disapproval. (Monitoring the Future Occasional Paper No. 19.) Ann Arbor, MI: Institute for Social Research. Blum, R. W., Beuhring, T., Shew, M. L., Bearinger, L. H., Sieving, R. E. & Resnick, M. D. (2000). The effects of race/ethnicity, income, and family structure on adolescent risk behaviors. American Journal of Public Health, 90, Bracht, N. & Kingsbury, L. (1990). Community organization principles in health promotion: A five-state model. In N. Bracht (Ed.), Health promotion at the community level (pp ). Beverly Hills, CA: Sage. Bry, B. H., McKeon, P. & Pandina, R. J. (1982). Extent of drug use as a function of number of risk factors. Journal of Abnormal Psychology, 91, Catalano, R. F. & Hawkins, J. D. (1996). The social development model: A theory of antisocial behavior. In J. D. Hawkins (Ed.), Delinquency and crime: Current theories (pp ). New York, NY: Cambridge University Press. Hawkins, J. D., Arthur, M. W. & Catalano, R. F. (1995). Preventing substance abuse. In M. Tonry & D. Farrington (Eds.), Building a safer society: Strategic approaches to crime prevention (Vol. 19, pp , Crime and justice: A review of research). Chicago, IL: University of Chicago Press. Hawkins, J. D., Catalano, R. F. & Associates. (1992). Communities that care: Action for drug abuse prevention (1 st ed.). San Francisco: Jossey-Bass. Hawkins, J. D., Catalano, R. F. & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, Johnston, L. D., O Malley, P. M., Bachman, J. G. & Schulenberg, J. E. (2006). Monitoring the Future national survey results on drug use, Volume I: Secondary school students (NIH Publication No ). Bethesda, MD: National Institute on Drug Abuse, 684. Newcomb, M. D. (1995). Identifying high-risk youth: Prevalence and patterns of adolescent drug abuse. In E. Rahdert & D. Czechowicz (Eds.), Adolescent drug abuse: Clinical assessment and therapeutic interventions (NIDA Research Monograph, 156). Washington, DC: U.S. Department of Health and Human Services. Newcomb, M. D. & Felix-Ortiz, M. (1992). Multiple protective and risk factors for drug use and abuse: Cross-sectional and prospective findings. Journal of Personality and Social Psychology, 51,

44 Newcomb, M. D., Maddahian, E. & Skager, R. (1987). Substance abuse and psychosocial risk factors among teenagers: Associations with sex, age, ethnicity, and type of school. American Journal of Drug and Alcohol Abuse, 13, Pollard, J. A., Hawkins, J. D. & Arthur, M. W. (1999). Risk and protection: Are both necessary to understand diverse behavioral outcomes in adolescence? Social Work Research, 23,

45 Appendix C The Social Development Strategy Appendix C: The Social Development Strategy 37

46 38